BISMARCK, N.D. | What to watch for in first Heitkamp-Cramer debate

BISMARCK, N.D.— The first debate between Sen. Heidi Heitkamp and Republican challenger Kevin Cramer comes as Heitkamp is under heavy pressure in a race Democrats badly need for any shot at controlling the Senate.

And it comes right after a major self-inflicted wound by Heitkamp’s campaign, with the senator apologizing this week for a newspaper ad attacking Cramer that improperly identified some survivors of domestic violence and sexual assault.

Heitkamp was already seen as one of the most vulnerable members of the Senate. She is the only statewide elected Democrat in solidly conservative North Dakota.

Some things likely to come up in Thursday evening’s debate at Bismarck State College:

KAVANAUGH — AND THE AD Heitkamp’s decision to vote against Brett Kavanaugh’s nomination to the Supreme Court is certain to get plenty of attention. In announcing her decision, Heitkamp cited Kavanaugh’s temperament during testy Senate Judiciary Committee hearings that included confrontations with some senators and emotional testimony.

Her decision was seen as a politically risky gamble that went against the grain of her conservative-dominated state. Heitkamp sought to cast it as further evidence of her independence. And she pounced on remarks from Cramer, who referred to the #MeToo movement as “this movement toward victimization.”

That led to the newspaper ad that ran in several North Dakota newspapers and was an open letter to Cramer that took issue with his remarks. Several women named in the ad either hadn’t authorized it or are not survivors of abuse, which led to backlash and Heitkamp’s subsequent apology.

Cramer, a three-term congressman, is certain to remind voters of the ad, which he has called a “revictimization of victims.”

TRADE Heitkamp is likely to renew her frequent attacks on Cramer over trade and tariffs in a state where agriculture accounts for about 25 percent of the workforce. Heitkamp has run several ads showing farmers in their soybean fields, complaining that Cramer has done nothing about the drop in crop prices. She has also portrayed Cramer as unwilling to challenge President Donald Trump on tariffs that she says could devastate farmers and others in the state.

Cramer has argued that Trump’s approach must be given time to work, adopting a “no pain, no gain” mantra. He is likely to point to Trump’s deal with Canada and Mexico as evidence that the president’s approach is working.

HEALTH CARE Heitkamp, like Democrats elsewhere, has hit Cramer hard with the assertion that repealing the Affordable Care Act would strip health care from thousands of people with pre-existing conditions. And she’s criticized Cramer for backing North Dakota’s involvement in a multistate lawsuit over whether or not the federal law is constitutional.

Cramer has argued the current health care system is broken. And he says every Republican proposal has included guaranteed coverage for pre-existing conditions.

WHAT ABOUT TRUMP? The president looms large in the race after carrying North Dakota by 36 points. Cramer has aligned himself closely with Trump and played up the story that the president personally recruited him into the race.

Although Heitkamp was a strong supporter of Hillary Clinton for president, she has spent years cultivating an image as a moderate, and is considered one of the least reliably partisan Democratic votes in the Senate. She largely backed North Dakota’s corporate interests on energy and has supported many of Trump’s Cabinet and judicial nominees, including Supreme Court pick Neil Gorsuch. Expect her to highlight much of that on Thursday.

But Heitkamp also voted against the tax cuts Trump championed and supported sanctuary cities. She also voted against several other Republican-sponsored bills, including legislation that allows states to deny federal funds for abortion providers, a failed GOP attempt to ban abortions after 20 weeks of pregnancy, and a repeal of the Affordable Care Act’s tax on high-cost health insurance plans.

Expect Cramer to pound on those themes, as well as Heitkamp’s deciding vote against repealing a rule related to methane emissions.